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S. N. Syed, S. Gupta, V. S. Brar, S. Grover, K. V. Chalam; Improvement of Visual Acuity and Resolution of Macular Edema Associated With Chronic Disciform Scars After Intravitreal Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5586.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate if intravitreal bevacizumab will improve retinal edema or subretinal fluid associated with chronic disciform scars secondary to macular degeneration
This is a retrospective case series of 10 eyes of 10 patients ages 65 to 84 years with disciform scars and overlying retinal edema or subretinal fluid documented on OCT. All patients were treated with 2 or more injections of intravitreal bevacizumab at monthy intervals and were followed with OCT and IVFA to evaluate response to injections.
All patients had 20/200 or worse visual acuity as measured with snellen visual acuity testing, prior to injections with no significant improvement in visual acuity on follow up ranging from 4 to 12 months. Average central macular thickness measurements on OCT decreased from 409.7 µm to 278.2 µm, with an average decrease of 131.5 µm. OCT demonstrated cystic retinal edema in all patients and additionally showed subretinal fluid in 1 patient. On follow up retinal edema resolved completely in 6 patients (p<0.01).
Though disciform scar represents the end stage of choroidal neovascularization, there does appear to be benefit in terms of anatomic improvement of retinal edema with active treatment. This suggests that VEGF is still actively involved at this stage of the disease process and actively responds to intravitreal therapy. Evaluation with visual functional questionnaire and low vision instrumentation pre and post injections may further delineate the advantages of reduction in retinal thickness with intravitreal bevacizumab.
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